Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences最新文献

{"title":"[Distribution characteristics of traditional Chinese medicine syndromes in patients with Wilson<b>'</b>s disease across all age groups].","authors":"Daiping Hua, Lanting Sun, Qiaoyu Xuan, Shang Xiang, Shiheng Shi, Wenming Yang, Han Wang","doi":"10.3724/zdxbyxb-2025-0873","DOIUrl":"https://doi.org/10.3724/zdxbyxb-2025-0873","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To investigate the distribution patterns of traditional Chinese medicine (TCM) syndromes in hepatolenticular degeneration (Wilson's disease, WD) and their characteristics across different age stages and clinical classifications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A cross-sectional study was conducted on 2969 WD patients who visited the First Affiliated Hospital of Anhui University of Chinese Medicine between March 2020 and February 2025. Patients were divided into five age groups: childhood (3-&lt;14 years), adolescence (14-&lt;18 years), young adulthood (18-&lt;45 years), middle age (45-&lt;60 years), and old age (≥60 years). Factor analysis was used to extract syndrome elements of disease location and disease nature, while cluster analysis was applied to summarize TCM syndrome patterns and to analyze their distribution across age stages and clinical classifications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The primary TCM syndrome elements of disease location in WD were the liver (65.88%),spleen (44.73%), and kidney (32.47%). The core disease nature syndrome elements were dampness (37.59%), heat (37.42%), and phlegm (32.70%), accompanied by yin deficiency (31.83%) and blood stasis (27.01%). Six TCM syndrome patterns were identified: internal retention of damp-heat (26.34%), syndrome of intermin-gled phlegm and blood stasis (24.59%), syndrome of stagnation of liver qi and spleen deficiency (20.04%), syndrome of yin deficiency of liver and kidney (16.30%), syndrome of deficiency of both qi and blood (6.87%), and syndrome of yang deficiency of spleen and kidney (5.86%). The distribution of TCM syndrome patterns showed clear age-related characteristics: childhood was predominantly characterized by internal retention of damp-heat and syndrome of yin deficiency of liver and kidney; adolescence by internal retention of damp-heat and syndrome of stagnation of liver qi and spleen deficiency; young adulthood by internal retention of damp-heat and syndrome of intermin-gled phlegm and blood stasis; middle age mainly by syndrome of intermin-gled phlegm and blood stasis; and old age by syndrome of yin deficiency of liver and kidney and syndrome of stagnation of liver qi and spleen deficiency. Regarding clinical classification, the distribution of TCM syndrome patterns also showed differences: internal retention of damp-heat was most prevalent in the hepatic type (35.48%), syndrome of intermin-gled phlegm and blood stasis predominated in the neurological type (36.52%), while the mixed type exhibited a complex pattern with co-occurrence of syndrome of intermin-gled phlegm and blood stasis, internal retention of damp-heat, and syndrome of stagnation of liver qi and spleen deficiency.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The distribution of TCM syndromes in WD exhibits significant age-stage characteristics and a clinical classification-syndrome pattern correspondence. This study preliminarily establishes an age stage-TCM syndrome pattern and clinical clas","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Anemoside B4 inhibits non-small cell lung cancer metastasis by modulating epithelial-mesenchymal transition mediated by the MAPK and Keap1/Nrf2 signaling pathways].","authors":"Qian Su, Lianting Liao, Lina Liu, Linyu Xiao, Yufang Shen, Shilin Yang, Renyikun Yuan, Hongwei Gao","doi":"10.3724/zdxbyxb-2025-0384","DOIUrl":"https://doi.org/10.3724/zdxbyxb-2025-0384","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the effect and mechanism of Anemoside B4 (AB4) on non-small cell lung cancer (NSCLC) metastasis by regulating epithelial-mesenchymal transition (EMT).</p><p><strong>Methods: </strong><i>In vitro</i>, the MTT assay was used to evaluate the effect of AB4 on the viability of human NSCLC cell lines A549 and H1975. Cell scratch and Transwell assays were performed to assess the effect of AB4 on the migration and invasion of A549 and H1975 cells induced by transforming growth factor-β1. Western blotting and immunofluorescence were used to detect the expression of proteins related to EMT, the mitogen-activated protein kinase (MAPK) signaling pathway, and the oxidative stress signaling pathway. <i>In</i><i>vivo</i>, a mouse model of melanoma lung metastasis was established by tail vein injection of B16-F10 cells to evaluate the effect of AB4 (20, 40 mg/kg) on melanoma lung metastasis. Blood routine parameters were measured using a hematology analyzer, pathological changes in lung tissue were observed by hematoxylin and eosin staining, and the expression of EMT-, MAPK-, and oxidative stress signaling pathway-related proteins in lung tissue was detected by Western blotting.</p><p><strong>Results: </strong><i>In vitro</i>, the MTT assay showed that AB4 (5, 10, 20 μmol/L) had no cytotoxic effects. Cell scratch and Transwell assays demonstrated that AB4 inhibited the migration and invasion of A549 and H1975 cells. Western blotting results showed that AB4 decreased the expression of N-cadherin, vimentin, Slug, and Snail while increasing E-cadherin expression in the EMT pathway; decreased Keap1 expression and increased Nrf2 expression in the oxidative stress pathway; and reduced the phosphorylation levels of JNK, ERK, and p38 in the MAPK pathway (all <i>P</i><0.05). <i>In</i><i>vivo</i>, AB4 alleviated weight loss, inhibited melanoma lung metastasis, and showed no significant effect on blood routine parameters in model mice. Additionally, AB4 suppressed EMT, oxidative stress, and the MAPK signaling pathway in the lung tissue of model mice, thereby reducing melanoma lung metastasis.</p><p><strong>Conclusions: </strong>AB4 inhibits the migration and invasion of NSCLC cells by modulating the Keap1/Nrf2-mediated oxidative stress and MAPK signaling pathways, thereby regulating EMT. <i>In</i><i>vivo</i> experiments further confirmed that AB4 effectively reduces metastasis by suppressing these signaling pathways in melanoma lung metastatic lesions.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147677140","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[The Chinese medicine Gandouling attenuates brain injury in hepatolenticular degeneration mice by inhibiting ferroptosis via the SIRT1/FoxO3 pathway].","authors":"Kaijian Wu, Ni Wang, Dapeng Zhao, Wangyun Wei, Wanqing Zhang, Jing Zhang","doi":"10.3724/zdxbyxb-2025-0622","DOIUrl":"https://doi.org/10.3724/zdxbyxb-2025-0622","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To investigate the mechanism by which the Chinese medicine Gandouling protects against brain injury in hepatolenticular degeneration (Wilson's disease) through regulation of the SIRT1/FoxO3 pathway-mediated ferroptosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;TX mice were randomly divided into six groups: model control, Gandouling, resveratrol (SIRT1 activator), Gandouling+resveratrol, EX-527 (SIRT1 inhibitor), and Gandouling+EX-527 groups, with DL mice serving as the blank control group. After a 4-week intervention, neurological function was assessed using the Morris water maze test, wire hanging test, and pole test. Apoptosis in basal ganglia tissue was detected by TUNEL assay. Reactive oxygen species (ROS) levels in basal ganglia tissue were measured using the DCFH-DA method, while ferrous iron (Fe²⁺) and malondialdehyde (MDA) levels were determined by colorimetric assays. Immunofluorescence was used to evaluate the fluorescence intensity of SIRT1 and FoxO3. The protein expression levels of SIRT1, FoxO3, GPX4, SLC7A11, ACSL4, FTH1, and P53 were assessed by Western blotting, and the mRNA expression levels of &lt;i&gt;Sirt1&lt;/i&gt; and &lt;i&gt;Foxo3&lt;/i&gt; were detected by qRT-PCR.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared with the blank control group, the model control group exhibited significant neurological impairment (prolonged escape latency, reduced platform crossing frequency, and prolonged pole-climbing time), increased neuronal apoptosis, decreased transcription and expression of &lt;i&gt;Sirt1&lt;/i&gt; (both &lt;i&gt;P&lt;/i&gt;&lt;0.01), increased transcription (&lt;i&gt;P&lt;/i&gt;&lt;0.05) and expression (&lt;i&gt;P&lt;/i&gt;&lt;0.01) of &lt;i&gt;Foxo3&lt;/i&gt;, and elevated levels of ROS, Fe²⁺, and MDA in basal ganglia tissue (all &lt;i&gt;P&lt;/i&gt;&lt;0.01). Expression levels of ferroptosis-inhibiting proteins (GPX4, SLC7A11, FTH1) were decreased (all &lt;i&gt;P&lt;/i&gt;&lt;0.01), while those of ferroptosis-promoting proteins (P53, ACSL4) were increased (all &lt;i&gt;P&lt;/i&gt;&lt;0.01). Both Gandouling and resveratrol monotherapy significantly reversed the above alterations: neurological function was improved, apoptosis was reduced, ROS, Fe²⁺, and MDA levels were decreased, &lt;i&gt;Sirt1&lt;/i&gt; transcription and expression were upregulated, &lt;i&gt;Foxo3&lt;/i&gt; transcription and expression were downregulated, ferroptosis-inhibiting proteins were increased, and ferroptosis-promoting proteins were decreased (all &lt;i&gt;P&lt;/i&gt;&lt;0.01), with comparable efficacy between the two treatments (&lt;i&gt;P&lt;/i&gt;&gt;0.05). Combined Gandouling and resveratrol treatment exhibited synergistic effects. EX-527 exacerbated neurological impairment and apoptosis, further increased ROS, Fe²⁺, and MDA levels, suppressed &lt;i&gt;Sirt1&lt;/i&gt; transcription and expression, elevated &lt;i&gt;Foxo3&lt;/i&gt; transcription and expression, and aggravated the dysregula-tion of ferroptosis-related proteins (all &lt;i&gt;P&lt;/i&gt;&lt;0.01). However, no significant differences were observed between the Gandouling+EX-527 group and the model control group (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). Additionally, the transcription levels of Sirt1 and &lt;i&gt;","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2026-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147634589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Metabolomics study on anti-inflammatory effects of Guanjie Zhentong Babu plaster in collagen-induced arthritis rats].","authors":"Tian Xu, Jinling Xu, Xiaolin Yang, Rong Shi, Liqiang Ni","doi":"10.3724/zdxbyxb-2025-0640","DOIUrl":"https://doi.org/10.3724/zdxbyxb-2025-0640","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To investigate the anti-inflammatory effects of Guanjie Zhentong Babu Plaster on collagen-induced arthritis (CIA) rats and its potential mechanisms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Rats were randomly divided into a normal control group and an experimental group. The experimental group was immunized with bovine type Ⅱ collagen emulsion to establish the CIA rat model, and then subdivided into the following groups: cold syndrome model group, heat syndrome model group, high-dose cold syndrome group, high-dose heat syndrome group, low-dose cold syndrome group, positive control cold syndrome group, positive control heat syndrome group, and blank plaster cold syndrome group, with 8 rats in each group. Arthritis index (AI) scores of paw joints were evaluated on day 0, day 4, day 7, and day 14 after drug administration. A plethysmometer was used to assess hind paw joint swelling. After completion of the pharmacodynamic evaluation, the rats were sacrificed, and hematoxylin and eosin staining was performed to observe histopathological changes in ankle joint tissues. Serum metabolite profiles were analyzed using ultra performance liquid chromatography coupled with linear ion trap quadrupole-Orbitrap mass spectrometry, and metabolic pathway enrichment analysis was conducted to explore the potential mechanisms of drug intervention. In addition, immunohistochemistry and enzyme-linked immunosorbent assay were performed to investigate the changes in tumor necrosis factor-α TNF-α, IL-17, and IL-10.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Compared with the cold syndrome model group, the high-dose cold syndrome group showed a significant improvement in AI scores at day 14 (&lt;i&gt;P&lt;/i&gt;&lt;0.05) and a significant reduction in hind paw joint swelling (&lt;i&gt;P&lt;/i&gt;&lt;0.01), accompanied by markedly alleviated histopathological damage of the ankle joint. In contrast, no significant changes were observed in the high-dose heat syndrome group compared with the heat syndrome model group. Metabolomics analysis revealed that arginine biosynthesis and purine metabolism pathways were markedly disrupted in the cold-syndrome model group, and after drug administration, the levels of L-citrulline was significantly increased, whereas the levels of uric acid and xanthine were significantly decreased in the high-dose cold syndrome group (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). Immunohistochemistry and enzyme-linked immunosorbent assay results indicated that, compared with the cold syndrome model group, TNF-α and IL-17 levels in synovial tissue and serum were significantly decreased (all &lt;i&gt;P&lt;/i&gt;&lt;0.05), whereas IL-10 levels were significantly increased (all &lt;i&gt;P&lt;/i&gt;&lt;0.01) in the high-dose cold syndrome group.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Guanjie Zhentong Babu Plaster can improve inflammatory responses and joint damage in CIA rats with cold syndrome. The mechanism may be related to the regulation of arginine metabolism and improvement of purine metabolism disorders, thereby coordinately mo","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"1-12"},"PeriodicalIF":0.0,"publicationDate":"2026-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147628754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[<i>Angelica sinensis</i> polysaccharide ameliorates endometriosis in rats by restoring autophagic homeostasis via inhibition of Keap1/Nrf2/HO-1-mediated oxidative stress].","authors":"Jie Li, Xiao Li, Xia Ji, Yao Huang, Zhanli Wang","doi":"10.3724/zdxbyxb-2025-0459","DOIUrl":"https://doi.org/10.3724/zdxbyxb-2025-0459","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate whether <i>Angelica sinensis</i> polysaccharide (ASP) ameliorates endometriosis (EMT) by suppressing oxidative stress and restoring autophagy via the Kelch-like ECH-associated protein 1 (Keap1)/nuclear factor erythroid 2-related factor 2 (Nrf2)/heme oxygenase-1 (HO-1) pathway.</p><p><strong>Methods: </strong>Rats were randomly divided into six groups (<i>n</i>=12 per group): normal control, model control, low-dose ASP, high-dose ASP, gestrinone, and high-dose ASP+recombinant Keap1 (rKeap1). EMT models were established in all groups except the normal control group. After successful modeling, treatments were administered once daily for 4 weeks. The mass and volume of ectopic endometrial tissue were measured. Histopathological changes were evaluated using hematoxylin and eosin staining. Levels of reactive oxygen species, malondialdehyde, and superoxide dismutase (SOD) were measured using commercial kits. The number of autophagosomes was observed under transmission electron microscopy. The relative fluorescence intensity of microtubule-associated protein light chain 3 (LC3) in endometrial tissue was detected by immunofluorescence staining. Western blotting was used to determine the protein expression levels of LC3-Ⅱ/LC3-Ⅰ, p62, Keap1, nuclear Nrf2, and HO-1.</p><p><strong>Results: </strong>Compared with the normal control group, the model control group showed increased glandular proliferation, pronounced vacuolization of glandular cells, and substantial inflammatory cell infiltration in ectopic endometrial tissue. Levels of reactive oxygen species, malondialdehyde, p62, and Keap1 were significantly increased, while SOD levels, autophagosome numbers, and LC3 fluorescence intensity were significantly decreased. Protein expression levels of LC3-Ⅱ/LC3-Ⅰ, nuclear Nrf2, and HO-1 were also significantly reduced (all <i>P</i><0.05). Compared with the model control group, the low- and high-dose ASP groups and the gestrinone group exhibited alleviated pathological damage, reduced mass and volume of ectopic endometrial tissue, decreased levels of reactive oxygen species, malondialdehyde, p62, and Keap1, and increased SOD levels, autophagosome numbers, LC3 fluorescence intensity, and protein expression levels of LC3-Ⅱ/LC3-Ⅰ, nuclear Nrf2, and HO-1 (all <i>P</i><0.05). However, co-administration of rKeap1 reversed the inhibitory effects of high-dose ASP on oxidative stress and its restorative effects on autophagic homeostasis in EMT rats.</p><p><strong>Conclusions: </strong><i>Angelica sinensis</i> polysaccharide may ameliorate endometriosis in rats by inhibiting Keap1-mediated activation of the Nrf2/HO-1 pathway, thereby suppressing oxidative stress and restoring autophagic homeostasis.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"1-10"},"PeriodicalIF":0.0,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Association between dynamic elevation of high-sensitivity cardiac troponin T and functional outcomes in patients with acute ischemic stroke].","authors":"Zhenhua Xi, Haitao Hu, Xin Huang, Yang Gao, Fengying Wu, Xinchun Jin, Xiaofeng Zhu, Yaode He, Yuping He, Lingqun Mao","doi":"10.3724/zdxbyxb-2025-0435","DOIUrl":"10.3724/zdxbyxb-2025-0435","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the association between in-hospital dynamic elevation of high-sensitivity cardiac troponin T (hs-cTnT) and early neurological deterioration (END) as well as 3-month functional outcomes in patients with acute ischemic stroke (AIS).</p><p><strong>Methods: </strong>Data of AIS patients who underwent two hs-cTnT measurements during hospitalization between March 2017 and November 2024 were extracted from the Comparison Influence to Prognosis of CTP and MRP in AIS Patients (CIPPIS) database (NCT03367286) for retrospective analysis. Patients were categorized into a dynamic elevation group and a non-elevation group based on whether their hs-cTnT increased by more than 20% from the baseline level. The incidences of END and 3-month functional independence were compared between the two groups. END was defined as a ≥4-point increase in the National Institutes of Health Stroke Scale (NIHSS) score within 7 days of onset, and functional independence was defined as a modified Rankin Scale (mRS) score 0-2. Binary logistic regression was used to analyze the relationship between hs-cTnT dynamic elevation and the outcomes. Sensitivity analysis (excluding patients with acute myocardial infarction or severe renal dysfunction) and subgroup analyses were performed to assess the robustness of the findings.</p><p><strong>Results: </strong>A total of 1049 patients were included (median age 73 years). Among them, 406 patients (38.7%) were female, 226 patients (21.5%) exhibited hs-cTnT dynamic elevation. Compared with the non-elevation group, the dynamic elevation group had a significantly higher incidence of END (9.71% <i>vs</i>. 15.42%, <i>P</i><0.05) and lower proportions of patients with 3-month mRS scores of 0-1 (37.75% <i>vs.</i> 26.57%, <i>P</i><0.01), 0-2 (48.71% <i>vs.</i> 36.71%, <i>P</i><0.01), and 0-3 (63.87% <i>vs.</i> 55.56%, <i>P</i><0.05). The 3-month all-cause mortality was also higher in the dynamic elevation group (9.20% <i>vs.</i> 14.01%, <i>P</i><0.05). After adjusting for confounders (including age, sex, baseline NIHSS score, baseline hs-cTnT level, TOAST classification, and reperfusion therapy), dynamic elevation of hs-cTnT remained independently associated with a higher risk of END (adjusted OR=1.73, 95%CI: 1.07-2.82, <i>P</i><0.05) and lower odds of achieving 3-month mRS scores of 0-1 (adjusted OR=0.65, 95%CI: 0.44-0.96, <i>P</i><0.05) and 0-2 (adjusted OR=0.67, 95%CI: 0.47-0.97, <i>P</i><0.05). The results were consistent in sensitivity analysis, and no significant interactions were observed across various subgroups (all interactions <i>P</i>>0.05).</p><p><strong>Conclusions: </strong>In patients with AIS, dynamic elevation of hs-cTnT is independently associated with an increased risk of END and poorer 3-month functional outcomes. This association may reflect the adverse impact of acute myocardial injury on stroke prognosis.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"137-144"},"PeriodicalIF":0.0,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12980115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Association of sodium-glucose linked transporter 2 inhibitors with functional outcomes at discharge in diabetic patients with acute ischemic stroke].","authors":"Xin Huang, Xiaoxiang Wang, Yiqing Jiang, Ke Shen, Zhenlei Jia, Xiangdong Ma, Bifeng Zhong, Yuping He, Min Lou","doi":"10.3724/zdxbyxb-2025-0474","DOIUrl":"10.3724/zdxbyxb-2025-0474","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the association between the use of sodium-glucose linked transporter 2 (SGLT2) inhibitors and functional outcomes at discharge in diabetic patients with acute ischemic stroke (AIS).</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using data from the Acute Stroke Patients for Stroke Management Quality Evaluation online database (CASE-Ⅱ, NCT04487340) for patients admitted between January 2022 and November 2024. Diabetic patients with AIS were categorized as SGLT2 inhibitor users or non-users (control group). Patients' functional outcomes were assessed using the modified Rankin Scale (mRS) score. Propensity score matching (PSM) was performed in a 1∶2 ratio. Multivariate logistic regression models were used to assess the association between SGLT2 inhibitor use and outcomes. Stratified analyses were performed based on pre-existing diabetes versus newly diagnosed diabetes during the hospitalization and the impact of long-term and short-term use of SGLT2 inhibitors on patients' functional outcomes at discharge was analyzed.</p><p><strong>Results: </strong>The study included 9220 patients (mean age 67±11 years; 39.38% female), of whom 1915 (20.77%) were SGLT2 inhibitor users. There were 1912 cases in the user group and 3683 cases in the non-user group after PSM. Before PSM, the proportion of patients with an mRS score 0-2 at discharge was significantly higher in the SGLT2 inhibitor group than that in the control group (79.84% <i>vs</i>. 69.19%, <i>P</i><0.01). After multivariable adjustment, SGLT2 inhibitor use remained significantly associated with higher proportion of mRS score 0-2 (adjusted OR=1.24, 95%CI: 1.08-1.42, <i>P</i><0.01) and mRS score 0-3 (adjusted OR=1.62, 95%CI: 1.32-1.99, <i>P</i><0.01) at discharge. Results were consistent after PSM. In stratified analyses, SGLT2 inhibitor use was associated with improved functional outcomes in both patients with pre-existing diabetes and those with newly diagnosed diabetes.</p><p><strong>Conclusions: </strong>Among diabetic patients with AIS, SGLT2 inhibitor use is independently associated with better functional outcomes at discharge, showing a potential benefit for short-term neurological recovery.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"129-136"},"PeriodicalIF":0.0,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12980116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Advances in targeted therapies for chronic spontaneous urticaria].","authors":"Linrun Zhou, Chenji Hu, Shiyan Wang, Rui Zhang","doi":"10.3724/zdxbyxb-2025-0784","DOIUrl":"10.3724/zdxbyxb-2025-0784","url":null,"abstract":"<p><p>Chronic spontaneous urticaria (CSU) is a common dermatological disorder marked by significant patient heterogeneity. Existing treatment strategies often fall short of adequately addressing patients' clinical needs. In the past decade, insights into the pathophysiology of CSU have catalyzed the development of novel targeted therapies, which can be categorized into three main approaches: targeting mast cells, targeting cytokines, and targeting Janus kinase (JAK) signaling. Mast cell-targeted strategies focus on surface receptors (<i>e.g</i>., activating receptors, the KIT receptor governing mast cell proliferation/survival, and inhibitory receptors) and intracellular pathways such as Bruton's tyrosine kinase. Cytokine-targeted therapies aim at specific mediators including IL-4, thymic stromal lymphopoietin, IL-17, IL-23, and IL-5. Regarding JAK-targeted therapy, besides approved JAK inhibitors, several novel agents, including dual-target inhibitors, are under investigation. This review systematically delineates recent advances in targeted therapies for CSU, comparing the features and clinical potential of different agents, with the aim of informing evidence-based and personalized management of CSU.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"163-172"},"PeriodicalIF":0.0,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12980122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146120333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Research progress on external cervical resorption].","authors":"Ran Chen, Mengyao Bian, Jin Zhao, Linna Qian, Ying Shi, Zhifang Wu","doi":"10.3724/zdxbyxb-2025-0778","DOIUrl":"10.3724/zdxbyxb-2025-0778","url":null,"abstract":"<p><p>External cervical resorption (ECR) is a progressive, osteoclast-mediated destructive disease of dental hard tissues that originates at the cervical region of the root. Characterized by its insidious onset and diagnostic challenges at early stages, ECR can lead to severe tooth structure loss and even tooth extraction. Although the precise patho-genesis remains unclear, it is thought to be associated with local stimuli, certain medications, and systemic conditions. Cone beam computed tomography (CBCT) is currently the key imaging modality for three-dimensional assessment and accurate staging of ECR. Treatment should be based on such three-dimensional evaluation and follow a stepwise strategy tailored to the extent, depth, and pulpal involvement of the lesion: minimally invasive restoration with bioactive materials for early or localized defects; comprehensive manage-ment including root canal treatment, intentional replantation, or combined guided tissue regeneration for lesions involving the pulp or exhibiting extensive spread; and extraction with site preservation as a final restorative-oriented option for non-retainable teeth. This review systematically elaborates on the etiological factors, pathological mechanisms, clinical manifestations, image-based classification systems, diagnosis, and management of ECR, aiming to provide insights for precise clinical decision-making. Future research directions, such as early biomarker identification and targeted pharmacological intervention, are also discussed.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"173-184"},"PeriodicalIF":0.0,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12980124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146067555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Comparison of functional outcomes between tenecteplase and alteplase as bridging thrombolysis prior to mechanical throm-bectomy for acute ischemic stroke patients with large vessel occlusion].","authors":"Zhenghao Shi, Jiansheng Yang, Zhenchan Lu, Yaojie Cai, Yi Zhu, Gongchun Huang, Hui Zhu, Min Lou, Jianhua Cheng","doi":"10.3724/zdxbyxb-2025-0639","DOIUrl":"10.3724/zdxbyxb-2025-0639","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the efficacy and safety of tenecteplase versus alteplase as bridging intravenous thrombolysis before mechanical thrombectomy in acute ischemic stroke (AIS) patients with large vessel occlusion.</p><p><strong>Methods: </strong>In this retrospective cohort study, data were extracted from the Acute Stroke Patients for Stroke Management Quality Evaluation online database (CASE-Ⅱ, NCT04487340). Patients with AIS and large vessel occlusion who received tenecteplase or alteplase followed by mechanical thrombectomy within 24 hours of symptom onset from December 2022 to March 2025 were included. The patients were divided into the tenecteplase group and the alteplase group. Propensity score matching (1∶4) was performed based on age, sex, door-to-needle time (DNT), door-to-puncture time (DPT), and onset-to-door time. Binary logistic regression and general linear models were used to compare 3-month functional and safety outcomes. Sensitivity analysis was conducted for patients with onset-to-needle time (ONT)≤4.5 h, and subgroup analyses were performed based on age, sex, baseline National Institutes of Health Stroke Scale (NIHSS) score, occlusion site, DNT and DPT.</p><p><strong>Results: </strong>Among 1505 enrolled patients, 250 received tenecteplase and 1255 received alteplase. No significant differences were observed in 3-month functional outcomes between the two groups (all <i>P</i>>0.05). However, the tenecteplase group had lower 3-month all-cause mortality (OR=0.676, 95%CI: 0.470-0.972, <i>P</i>=0.032). After matching, 224 tenecteplase-treated and 767 alteplase-treated patients were included. There were no significant differences in functional or safety outcomes between the two groups (all <i>P</i>>0.05). Sensitivity analysis showed that among patients with an onset-to-needle time (ONT) ≤4.5 hours, there were no statistically significant differences in 3-month functional or safety outcomes between the tenecteplase group and the alteplase group (all <i>P</i>>0.05). Subgroup analyses indicated that no statistically significant differences in 3-month functional independence were observed across all subgroups (all <i>P</i>>0.05).</p><p><strong>Conclusions: </strong>In AIS patients with large vessel occlusion undergoing bridging thrombolysis before mechanical thrombectomy, tenecteplase and alteplase showed comparable 3-month functional and safety outcomes.</p>","PeriodicalId":24007,"journal":{"name":"Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences","volume":" ","pages":"121-128"},"PeriodicalIF":0.0,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12980118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145991112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}